Public Health PUBH 6003: Principles and Practice of Epidemiology Final Study Guide

Who is Imhotep ( BC)? - Egyptian founder of medicine. Diagnosed and treated over 200 diseases, performed surgery, and practiced some dentistry. He extracted medicine from plants . Was also a master architect and credited as the builder of the first pyramid at Saqqara. Who was Hippocrates (460-377 BC)? - Was regarded as the "Father of Medicine", until evidence on the contributions of Imhotep surfaced. Wrote "On Airs, Waters, and Places" which made many observations about environmental and behavioral causes of disease. Who was Girolamo Fracastoro ()? - Italian physician and poet. Wrote "De Contagione et contagiosis morbis", a treatise on the concept of contagious disease and infection. He also coined the term 'syphilis'. He proposed a scientific germ theory of disease 300 years before its empirical formulation by Louis Pasteur and Robert Koch. Who was John Graunt ()? - Haberdasher and demographer. Developed statistical and census methods. Developed first life table. Analyzed mortality in London to study onset and spread of the plague. Who was Bernadino Ramazzini ()? - Professor of Medicine in Modena, Italy. Wrote a book entitled ?The Diseases of Workers? (De Morbis Artificium Diatriba) that became influential in the area of occupational medicine and health. First to observe that disease among workers arose from harmful exposures encountered in the workplace. He was also 1st to observe higher rates of breast cancerWho was Edward Jenner ()? - Edward Jenner (): English surgeon. Observed persons infected with cowpox appeared to be protected against smallpox. In 1768, administered cowpox material to 8-year old boy. Later, he exposed the boy to smallpox. First 'vaccine trial'. Who was James Lind ()? - English surgeon. Conducted first clinical trials in 1747 among British sailors to examine effects of fresh fruits on preventing scurvy (before we knew of the concept of vitamins and vitamin deficiency) Who was William Farr ()? - English physician. A contemporary of John Snow. Worked for the General Register Office. Responsible for collecting official medical statistics for England and Wales. Set up a system for routinely recording causes of death which played an essential role in Snow's investigations of cholera mortality. Who was John Snow ()? - British Physician. Queen Victoria's anesthesiologist for the birth of her 8th child. Called the 'Father of Modern Epidemiology' for his work on several cholera outbreaks in London. Identified the means of transmission decades before the discovery of the cholera vibrio. Who was Ignaz Semmelweis ()? - Hungarian physician. Called the 'savior of mothers' for his seminal work on reducing the rate of puerperal fever by hand washing and sanitary practices. Resulted in a reduction of the rate of this often fatal disease (childbed fever) among mothers 10-fold. Conducted systematic studies to verify this. Who was Florence Nightingale ()? - Pioneer of profession of nursing. Made several contributions to the field of epidemiology. Was an excellent statistician and a great influence on the British Army Sanitary Commission. Was an expert in the visual and graphical depiction of data. First elected female member of the Royal Statistical Society.Who was Alice Hamilton ()? - A leading expert in occupation health and a pioneer in the field of toxicology. In 1919, became the first woman appointed to the faculty at the Harvard Medical School. From , served as the only woman member of the League of Nations Health Committee. What is epidemiology? - The study of the distribution and determinants of disease frequency in human populations and the application of this study to control health problems The study of upon people What is disease frequency? - Count cases, need system records What is disease distribution? - Who, when, where What is a determinant? - Characteristic that influences whether or not disease occurs Epidemiologic research assumes... - Disease occurrence is not random Systematic investigation of different populations can identify causal and preventive factors Making comparisons is the cornerstone of systematic investigations What are some uses of epidemiology? - Determining etiological or causal factors of disease Describing the distribution of a disease in a community or a populationPredicting disease occurrence, impact, and distribution in a community Estimating an individual's chance of suffering from diseases (risk) Evaluating preventive, therapeutic, and intervention activities Measuring the efficacy of health measures Studying historical disease trends Identifying disease syndromes Planning for current health needs Predicting future health care needs Provides the evidence base for establishing and evaluating public health policy What is primary prevention? - Actions taken to prevent the development of disease among persons who do not have the disease What is secondary prevention? - Actions taken among people who have already developed a disease to improve their prognosis; refers to early detection (screening) and early intervention What is tertiary prevention? - Tertiary Prevention - Consists of the prevention of disease progression and suffering after a disease is clinically obvious and a diagnosis has been established.Examples include routine screening for and management of early renal, eye and foot problems among diabetics. Often called "disease management." What is the natural progression in epidemiologic reasoning? - 1st - Suspicion that a factor influences disease occurrence. Arises from clinical practice, lab research, examining disease patterns by person, place and time, prior epidemiologic studies 2nd - Formulation of a specific hypothesis 3rd - Conduct epidemiologic study to determine the relationship between the exposure and the disease. Need to consider chance, bias, confounding when interpreting the study results. 4th - Judge whether association may be causal. Need to consider other research, strength of association, temporal aspects, etc. What is the epidemiologic triad? - Host, vector, environment, agent Disease described as result of interaction between: a.) Susceptible host b.) Appropriate agent c.) Appropriate environment d.) Ability of agent to affect the host e.) Biologic/social host characteristics Model initially developed for infectious diseases but can apply to all diseases/conditions What are some agents of disease? - Infectious organisms (note that some infectious agents require transmission by vectors)Biologic agents - allergens, vaccines, others Chemical agents Physical agents Psychological/sociological agents What is a rodent vector? - Responsible for transmission of diseases like hantavirus, lassa fever, plague Domestic habitat affected by rainfall, climatic changes, types of habitats What is a mosquito vector? - Responsible for transmission of diseases like malaria, encephalitis, West Nile Fever, and others. Affected by climate change, habitat change, flooding, etc. What is descriptive epidemiology? - Describe patterns of disease by person, place, and time (the ?other? epidemiologic triad) Person: Who is getting the disease? (for example, what is their age, sex, religion, race, educational level etc?) Disease and risk factors are not randomly distributed across populationsDisease is related to environmental and personal characteristics that vary by: a.) Person b.) Place c.) Time Goal of descriptive epidemiology is to determine the groups who are most at risk (and ultimately, why) Characteristics of 'place' in epidemiology... - Geographic differences may result from differences in: a.) Inhabitants b.) Environment c.) Data Quality We can examin